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Contact Information

ICEESHO BETHEL, RRT
2086 JODECO RD # 1674
MCDONOUGH, GA30253-5220
 Phone: 678-763-9797
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatric Care

2278G0305X
 

Home Care

2278H0200X
Indicates primary specialty

NPI Profile & details for ICEESHO BETHEL · (Female)

NPI Number 1619227576
Status Active
Credentials RRT
Entity Individual
Enumeration date 09/18/2012
Last updated 03/23/2026 - About 2 months ago
Sole proprietor 1 Yes
Identifiers
  • GA License # 7058
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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